By Guido Bocci, Giulio Francia
This ebook analyzes all features of metronomic chemotherapy, a brand new technique concerning low-dose, long term, and often administered treatment that has preclinical and scientific task in quite a few tumors. After a gap part at the pharmacological bases of metronomic chemotherapy, together with its antiangiogenic results and influence on immunity, preclinical experiences on a variety of periods of drug are mentioned. medical purposes of metronomic chemotherapy in a large choice of tumors are then addressed intimately, with description of the result of all released reviews. The scientific pharmacology of metronomic chemotherapy can be thought of intensive, encompassing pharmacokinetics, pharmacogenetics, pharmacoeconomics, and opposed drug reactions. The booklet closes through describing the position of this treatment within the veterinarian clinic.
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Additional info for Metronomic Chemotherapy: Pharmacology and Clinical Applications
Sample text
1 E. Fremder and Y. Shaked Introduction Initial studies which investigated the mechanism of action of low-dose metronomic (LDM) chemotherapy demonstrated that this treatment regimen solely acts by inhibiting tumor angiogenesis. Both Browder et al. and Klement et al. – the first two backto-back studies introducing the concept of LDM chemotherapy – showed that low-dose cyclophosphamide (CTX) or vinblastine led to significant antitumor activity in Lewis lung carcinoma and neuroblastoma, respectively [1, 2].
Hanahan and colleagues termed this combined regimen as a “chemo-switch” in which MTD chemotherapy (either alone or in combination with targeted agents) is followed by LDM maintenance therapy [52]. In the clinic, the combination of MTD and LDM therapy was recently tested in a multi-targeted chemo-switch regimen using sorafenib, gemcitabine, and LDM capecitabine for the treatment of metastatic renal cell cancer. The authors reported that the response rates of the combined therapy were greater than what was documented for gemcitabine and capecitabine or sorafenib monotherapy.
They found that levels of CEPs which were rapidly elevated following VDA therapy were significantly inhibited when such therapy was combined with LDM CTX. These anti-vasculogenic effects resulted in less colonization of BMDCs at the treated tumor, which is often seen following VDA therapy. The authors concluded that the combination of VDA and LDM CTX resulted in prolonged tumor control, in part due to the anti-vasculogenic activity of the metronomic chemotherapy [29]. Clinically, CEC and CEP levels were evaluated in cancer patients undergoing LDM chemotherapy to assess their prognostic or predictive value following antiangiogenic therapy.